What Medicare-for All May look like

We are many years away from M4A becoming reality, but unless some major unknown changes occur first, its coming.

We have years of rhetoric ahead of us, years of promises, optimistic assumptions and inaccurate criticism. Following is a sample of legislation already introduced. You can see a pattern of misinformation (intended or otherwise) and unrealistic assumptions emerging.

For example, look at the funding. Nearly all the tax increases are skewed toward higher income Americans. That is neither practical nor fair. Look at the restrictions on provider choice and prohibition on private insurance. Even the U.K. allows the purchase of private insurance (generally to avoid waiting time and improve access to specialists).

And look at the National Board of Universal Quality and Access to provide advice on quality, access, and affordability. That is code for “how the heck will we manage costs after we implement this thing?”

Don’t get caught up in the grand promises of M4A, JUST LOOK AND UNDERSTAND BEFORE YOU LEAP.

Introduced in House (01/24/2017)

Expanded & Improved Medicare for All Act

This bill establishes the Medicare for All Program to provide all individuals residing in the United States and U.S. territories with free health care that includes all medically necessary care, such as primary care and prevention, dietary and nutritional therapies, prescription drugs, emergency care, long-term care, mental health services, dental services, and vision care.

Only public or nonprofit institutions may participate. Nonprofit health maintenance organizations (HMOs) that deliver care in their own facilities may participate.

Patients may choose from participating physicians and institutions.

Health insurers may not sell health insurance that duplicates the benefits provided under this bill. Insurers may sell benefits that are not medically necessary, such as cosmetic surgery benefits.

The bill sets forth methods to pay institutional providers and health professionals for services. Financial incentives between HMOs and physicians based on utilization are prohibited.

The program is funded: (1) from existing sources of government revenues for health care, (2) by increasing personal income taxes on the top 5% of income earners, (3) by instituting a progressive excise tax on payroll and self-employment income, (4) by instituting a tax on unearned income, and (5) by instituting a tax on stock and bond transactions. Amounts that would have been appropriated for federal public health care programs, including Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP), are transferred and appropriated to carry out this bill.

The program must give employment transition benefits and first priority in retraining and job placement to individuals whose jobs are eliminated due to reduced clerical and administrative work under this bill.

The Department of Health and Human Services must create a confidential electronic patient record system.

The bill establishes a National Board of Universal Quality and Access to provide advice on quality, access, and affordability.

The Indian Health Service must be integrated into the program after five years. Congress must evaluate the continued independence of Department of Veterans Affairs health programs.

10 comments

How the hell is M4A going to save any money with all the new spending just to set up the M4A system. Remember the 1 billion plus wasted on setting up PPACA and all the state run exchanges that lost money and closed.

Talk to the Canadians about government healthcare. Long wait times. 3 years to get a family doctor. No doctors at the clinic today, you will have to come back tomorrow. Need a tetanus shot because you stepped on a nail on Monday, we are out of tetanus shots, please come back on Friday. Time to go to the for profit clinic in Canada $900 = NOT!

Canadian tax rates local and federal Quebec California tax rates local and federal

“Nearly 50 years ago, at the time of Medicare’s enactment, it was projected that the federal government would spend $9 billion on Part A hospital services in 1990. Actual spending in that year totaled $67 billion—an increase of 644% compared with initial estimates.

“Likewise, government officials originally projected that Medicare Part B physician services would require ‘federal appropriations of about $500 million a year from general tax revenues.’ Last year, the federal outlay for that program was $163.8 billion—overshooting the original estimate by more than 4,400%.”

So, M4A will cost 1.6 trillion per year instead of 1 trillion, still not good for the taxpayers.
I bet it will be closer to 2+ trillion per year. For less services and much longer wait times.
NO THANKS!
We must stop the M4A madness, now.

This sounds good, however, what will the cost of RX’s be with free healthcare for all? Also, what will this do to the Federal budget? I can’t believe regardless of the increase in taxes that it won’t effect the budget which could cause us a further deficit. Other issues include the many people who employed with private healthcare agencies, what about their jobs? Will they be working for Medicare? Many if’s in regard to this type change and factors to be considered, If RX prices go up how are the present/future seniors to afford the rising costs, and will there be a formulary whereas patients would not be able to get the newest most effective meds without out of pocket high costs for these as it presently is for seniors now. . I like the idea of one provider for all however that seems like socialist medicine, rather than a choice. without extremely high costs. It seems as though all providers, doctors, nurses, providers of health insurance would all be paid by the Federal government rather than by private sources. I wonder if all these issues are being taken into concern when this proposal was made. There would be a lot of issues that would need to be taken into consideration with this proposal happening.

The push for M4A is greed. If we move to M4A provided for by the government, it lets the employer off the hook. 70% of families get their healthcare from an employer sponsored plan. Once M4A is passed, employers will save billions and middle class tax rates will be above 50% to pay for it. But, IT IS FREE RIGHT!

I suspect there will be hefty taxes on employers equal to or close to the average 8% of payroll employers now spend. Employers will be happy in most cases until they realize they have lost all control over costs.

Your 70% figure is incorrect. According to the CBO, in 2016 there were 272 million people under age 65. 155 million (57%) obtained their coverage from their employer, 90 million (33%) from other sources, and 27 million (10%) were uninsured. One way to look at this is that 57% of people under age 65 received health insurance subsidized by everyone else in the country. This is because they received significant compensation from their employer (in the form of employer contributions to insurance premiums) that were taxed at a rate of 0%. If my employer pays for my car insurance, life insurance, or long term disability insurance, their payment counts towards my income. Why do we pretend that employer payments for medical insurance premiums aren’t income?

Everlyn, I don’t like “medicare” for all, I much prefer mediCAID for all since it pay 100% of medical costs versus 80%. You people against this fail to realize the bottom FIFTY yes 50% of Americans make less that 15$ an hour per person per job! They can NOT afford to pay 20% of their hospital visit making 5 to 15 dollars an hour!!! MediCAID prescriptions are FREE fyi. If you haven’t been paying attention the deficit will go DOWN having a Public Option! If we are SUPPOSEDLY the “best” country in the world (we’re actually OUT of the top TWENTY for average standard of living)